Dog Initial Interview Form

Dog Initial Interview Form Great News! You would like to adopt from Woodside Animal Centre. We just need to get a few details from you. Please fill in the whole form and we ask that you answer honestly so that we can find the right animal for you. Please note... you cannot adopt an animal on behalf of another person. A few details about you
Address Please provide your home address
Postcode Please provide your home postcode
Title Please provide your title
Alternative Title Please provide your preferred title
Forename Please provide you forename
Surname Please provide your surname
Would you like to include a joint applicant? Would you like to include a joint applicant?
Joint Applicant Title Please provide a title for the joint applicant
Alternative Title Please provide your preferred title
Joint Applicant Forename Please provide the surname of the joint applicant
Joint Applicant Surname Please provide the surname of the joint applicant
Contact Numbers Please provide your contact telephone number(s)
Email Please provide your email address
Is there a particular dog you are interested in? *
How did you hear about the dog you are interested in? *
A little about your home
Type of property you occupy? What type of property is your home?
Please specify Please describe your home
Do you Please let us know if you own your home or pay rent
If you rent, we will need to see written permission from your landlord.
Do you have a garden? Please let us know if you have a garden available
Is the garden secure, not allowing a dog to escape?
Please provide details of provision that could be made to ensure a dog cannot escape
What is the minimum height of your fence/gate (in feet)?
What is the maximum height of your fence/gate (in feet)?
How many people live at home?
Adults How many people over 18 years old (including yourself) live in your home?
Children How many children live in your home?
Children's ages Please provide the ages of the children in your home
Any visiting children? Do children visit your home?
Visiting children ages Please provide the ages of any visiting children
Do the children sleep at your home overnight? Do the children sleep at your home overnight?
Frequency of visits Please let us know the frequency of visits
Do you own other dogs? Do you own any other dogs?
Please state gender, age and breed Please state gender, age and breed
Are your other dogs fully vaccinated? Are your other dogs fully vaccinated?
(Vaccination cards will need to be seen before re-homing will commence)
Are they neutered? Have your existing dogs been neutered?
What other animals do you own? What other animals do you own?
A little about your lifestyle
Are you planning any of the following within the next two months? Please let us know if you are planning to move house or go on holiday in the next two months
Will the dog have human company all day? Will the dog have human company all day?
How many hours do you expect to leave the dog alone during a normal day? How many hours do you expect to leave the dog alone during a normal day?
How active are you?
How would you describe your home?
Your experience
Have you, as an individual, owned dogs before? Have you, as an individual, owned dogs before?
What breeds have you owned previously? What breeds have you owned previously?
What happened to them? Please let us know what happened to your previous dogs
What happens next A volunteer working with RSPCA Leicestershire Branch (Woodside Animal Centre) will need to visit you to undertake a home visit.
Do you agree that a volunteer home visitor makes a pre and post home visit (please note that you may be telephoned from a 'withheld number') *
1st Signature Please sign
2nd signature Please sign
Whilst every care is taken to advise you as the adopter of all the information regarding the animal, we cannot guarantee the animal's behaviour. All of our dogs are for pet purposes only (unless specified) and they must be able to live indoors (unless specified otherwise) as part of your family.
	Please tick this box if you agree to allow the dog to live indoors
RSPCA Leicestershire, Peterborough & Branch (Woodside Animal Centre ) operate a reserve policy on it's animals. In the event that you become first reserve on an animal we would like to be able to contact you. If you consent for us to contact you in this situation please provide details of how you would like Woodside to get in touch with you. (Response required within 48 hours)
Preferred Contact Method
The information you have provided on this form will be used by the RSPCA Leicestershire, Peterborough & Rutland Branch (Woodside Animal Centre) for the purposes of facilitating your application to foster or adopt a pet. We respect your privacy and will keep your information safe and secure and will only use it in accordance with our Privacy Policy. We will keep your information on file for one month and may use it to contact you about other available animals which match your requirements, if you are unsuccessful with your initial choice. A copy of our privacy policy is available upon request or may be viewed on our website at www.rspcaleicester.org.uk. Our policy applies whether your data is supplied directly to the Leicestershire, Peterborough & Rutland Branch or shared with us by the RSPCA National Society.

Dog Initial Interview Form

Dog Initial Interview Form

A few details about you

A little about your home

A little about your lifestyle

Your experience

What happens next